Growth hormone (GH), which is secreted from the pituitary gland, stimulates growth of all tissues of the body that are capable of growing. In addition, growth hormone is known to have the following basic effects on the metabolic process of the body;
1. Increased rate of protein synthesis in substantially all cells of the body; PA1 2. Decreased rate of carbohydrate utilization in cells of the body; PA1 3. Increased mobilization of free fatty acids and use of fatty acids for energy. PA1 e is 0 or 1; PA1 n and w are each independently 0, 1 or 2, provided that w and n cannot both be 0 at the same time; PA1 Y is oxygen or sulfur; PA1 R.sup.1 is hydrogen, --CN, --(CH.sub.2).sub.q N(X.sup.6)C(O)X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 (CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q C(O)OX.sup.6, --(CH.sub.2).sub.q C(O)O(CH.sub.2).sub.t --A.sup.1, --CH.sub.2).sub.q OX.sup.6, --(CH.sub.2).sub.q OC(O)X.sup.6, --CH.sub.2).sub.q OC(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)X.sup.6, --(CH.sub.2).sub.q C(O)(CH.sub.2 .sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)OX.sup.6, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q S(O).sub.m (X.sup.6), --(CH.sub.2).sub.q A(O).sub.m (CH.sub.2).sub.t --a.sup.1, --(C.sub.1 -C.sub.10)alkyl, --(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q --(C.sub.3 -C.sub.7)cycloalkyl, --(CH.sub.2).sub.q --Y.sup.1 --(C.sub.1 -C.sub.6)alkyl, --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --A.sup.1 or --CH.sub.2).sub.q --Y.sup.1 (CH.sub.2).sub.t --(C.sub.3 -C.sub.7)cycloalkyl; PA1 R.sup.2 is hydrogen, (C.sub.1 -C.sub.8)alkyl, --(C.sub.0 -C.sub.3)alkyl-(C.sub.3 -C.sub.8)cycloalkyl, --(C.sub.1 -C.sub.4)alkyl-A.sup.1 or A.sup.1 ; PA1 where the alkyl groups and the cycloalkyl groups in the definition of R.sup.2 are optionally substituted with hydroxyl, --C(O)OX.sup.6, --C(O)N(X.sup.6)(X.sup.6), --N(X.sup.6)(X.sup.6), --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)A.sup.1, --C(O)(X.sup.6), CF.sub.3, CN or 1, 2 or 3 halogen; PA1 R.sup.3 is A.sup.1, (C.sub.1 -C.sub.10)alkyl, --(C.sub.1 -C.sub.6)alkyl-A.sup.1, --(C.sub.1 -C.sub.6)alkyl-(C.sub.3 -C.sub.7)cycloalkyl, --(C.sub.1 -C.sub.5)alkyl-X.sup.1 --(C.sub.1 -C.sub.5)alkyl, --(C.sub.1 -C.sub.5)alkyl-X.sup.1 --(C.sub.0 -C.sub.5)alkyl-A.sup.1 or --(C.sub.1 -C.sub.5)alkyl-X.sup.1 --(C.sub.1 -C.sub.5)alkyl-(C.sub.3 -C.sub.7)cycloalkyl; PA1 R.sup.4 is hydrogen, (C.sub.1 -C.sub.6)alkyl or (C.sub.3 -C.sub.7)cycloalkyl, or R.sup.4 is taken together with R.sup.3 and the carbon atom to which they are attached and form (C.sub.5 -C.sub.7)cycloalkyl, (C.sub.5 -C.sub.7)cycloalkenyl, a partially saturated or fully saturated 4- to 8-membered ring having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen, or is a bicyclic ring system consisting of a partially saturated or fully saturated 5- or 6-membered ring, fused to a partially saturated, fully unsaturated or fully saturated 5-or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen; PA1 X.sup.4 is hydrogen or (C.sub.1 -C.sub.6)alkyl or X.sup.4 is taken together with R.sup.4 and the nitrogen atom to which X.sup.4 is attached and the carbon atom to which R.sup.4 is attached and form a five to seven membered ring; PA1 R.sup.6 is a bond or is ##STR6## where a and b are independently 0, 1, 2 or 3; X.sup.5 and X.sup.5a are each independently selected from the group consisting of hydrogen, trifluoromethyl, A.sup.1 and optionally substituted (C.sub.1 -C.sub.6)alkyl; PA1 or X.sup.5 is taken together with X.sup.5a and the carbon atom to which they are attached and form a partially saturated or fully saturated 3- to 7-membered ring, or a partially saturated or fully saturated 4- to 8-membered ring having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen; PA1 R.sup.7 and R.sup.8 are independently hydrogen or optionally substituted (C.sub.1 -C.sub.6)alkyl; PA1 R.sup.7 and R.sup.8 can be taken together to form --(CH.sub.2).sub.r --L--(CH.sub.2).sub.r --; PA1 A.sup.1 for each occurrence is independently (C.sub.5 -C.sub.7)cycloalkenyl, phenyl or a partially saturated, fully saturated or fully unsaturated 4- to 8-membered ring optionally having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen, a bicyclic ring system consisting of a partially saturated, fully unsaturated or fully saturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen, fused to a partially saturated, fully saturated or fully unsaturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen; PA1 r for each occurrence is independently 1, 2 or 3; PA1 X.sup.2 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, or optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, where the optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.2 are optionally independently substituted with --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)OX.sup.3, 1 to 5 halogens or 1 to 3 OX.sup.3 ; PA1 X.sup.3 for each occurrence is independently hydrogen or (C.sub.1 -C.sub.6)alkyl; PA1 X.sup.6 is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, (C.sub.2 -C.sub.6)halogenated alkyl, optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, (C.sub.3 -C.sub.7)-halogenatedcycloalkyl, where optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.6 is optionally independently substituted by 1 or 2 (C.sub.1 -C.sub.4)alkyl, hydroxyl, (C.sub.1 -C.sub.4)alkoxy, carboxyl, CONH.sub.2, --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, carboxylate (C.sub.1 -C.sub.4) alkyl ester, or 1H-tetrazol-5-yl; or PA1 when there are two X.sup.6 groups on one atom and both X.sup.6 are independently (C.sub.1 -C.sub.6)alkyl, the two (C.sub.1 -C.sub.6)alkyl groups may be optionally joined and, together with the atom to which the two X.sup.6 groups are attached, form a 4- to 9- membered ring optionally having oxygen, sulfur or NX.sup.7 ; PA1 m for each occurrence is independently 0, 1 or 2; PA1 X.sup.6 and X.sup.12 cannot be hydrogen when it is attached to C(O) or SO.sub.2 in the form C(O)X.sup.6, C(O)X.sup.12, SO.sub.2 X.sup.6 or SO.sub.2 X.sup.12 ; and PA1 when R.sup.6 is a bond then L is N(X.sup.2) and each r in the definition --(CH.sub.2).sub.r --L--(CH.sub.2).sub.r -- is independently 2 or 3. PA1 R.sup.6 is ##STR7## where Z.sup.1 is a bond and a is 0 or 1; X.sup.5 and X.sup.5a are each independently hydrogen, trifluoromethyl, phenyl, optionally substituted (C.sub.1 -C.sub.6)alkyl; PA1 or X.sup.5 and X.sup.7 are taken together to form a (C.sub.1 -C.sub.5)alkylene bridge, and the other substituents are not defined for the "A Group" compounds are as defined for formula (I) hereinabove. PA1 where the aryl portion(s) of the groups defined for R.sup.3 are optionally substituted with one to three substituents, each substituent being independently selected from the group consisting of methylenedioxy, F, Cl, CH.sub.3, OCH.sub.3, OCF.sub.3, OCF.sub.2 H and CF.sub.3. PA1 R.sup.7 and R.sup.8 are each hydrogen; and PA1 R.sup.3 is phenyl-CH.sub.2 --O--CH.sub.2 --, phenyl-CH.sub.2 --S--CH.sub.2 --, 1-naphthyl-CH.sub.2 --, 2-naphthyl-CH.sub.2 --, phenyl-(CH.sub.2).sub.3 -- or 3-indolyl-CH.sub.2 --; PA1 Y is O; R.sup.2 is hydrogen, --(C.sub.0 -C.sub.3)alkyl-(CH.sub.3 -C.sub.8)cycloalkyl, phenyl or (C.sub.1 -C.sub.8)alkyl where the (C.sub.1 -C.sub.8)alkyl group is optionally substituted with hydroxyl, --CF.sub.3 or 1 to 3 halogen. PA1 R.sup.1 is --(CH.sub.2).sub.r --A.sup.1 ; PA1 and R.sup.3 is phenyl-CH.sub.2 --O--CH.sub.2 --, phenyl-(CH.sub.2).sub.3 -- or 3-indolyl-CH.sub.2 --, where the aryl portion is optionally substituted with one to three substituents, each substituent being independently selected from the group consisting of F, Cl, Me, OMe, CF.sub.3, OCF.sub.3 or OCF.sub.2 H. PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is methyl and R.sup.3 is --(CH.sub.2).sub.3 -phenyl; PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is methyl and R.sup.3 is 3-indolyl-CH.sub.2 --; PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is ethyl and R.sup.3 is 3-indolyl-CH.sub.2 --; PA1 R.sup.1 is --CH.sub.2 -4-fluoro-phenyl, R.sup.2 is methyl and R.sup.3 is 3-indolyl-CH.sub.2 --; PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is methyl and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -phenyl; PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is ethyl and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -phenyl; PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is --CH.sub.2 --CF.sub.3 and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -phenyl; PA1 R.sup.1 is --CH.sub.2 -4-fluoro-phenyl, R.sup.2 is methyl and R.sup.3 is --(CH.sub.2)--O--CH.sub.2 -phenyl; PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is t-butyl and R.sup.3 is --(CH.sub.2)--O--CH.sub.2 -phenyl; or PA1 R.sup.1 is --CH.sub.2 -phenyl, R.sup.2 is methyl and R.sup.3 is --(CH.sub.2)--O--CH.sub.2 -3,4-di-fluoro-phenyl. PA1 where A.sup.1 in the definition of R.sup.1 is phenyl, thienyl, thiazolyl, pyridyl or pyrimidyl which is optionally substituted with one to three substituents, each substituent being independently selected from the group consisting of F, Cl, Me, OMe, CF.sub.3, OCF.sub.3 and OCF.sub.2 H; PA1 and R.sup.3 is phenyl-CH.sub.2 --O--CH.sub.2 --, phenyl-(CH.sub.2).sub.3 -- or 3-indolyl-CH.sub.2 --, where the aryl potion is optionally substituted with one to three substituents, each substituent being independently selected from the group consisting of F, Cl, Me, OMe, CF.sub.3, OCF.sub.3 or OCF.sub.2 H. PA1 R.sup.3 is selected from the group consisting of 1-indolyl-CH.sub.2 --, 2-indolyl-CH.sub.2 --, 3-indolyl-CH.sub.2 --, 1-naphthyl-CH.sub.2 --, 2-naphthyl-CH.sub.2 --, 1-benzimidazolyl-CH.sub.2 --, 2-benzimidazolyl-CH.sub.2 --, phenyl-(C.sub.1 -C.sub.4)alkyl-, 2-pyridyl-(C.sub.1 -C.sub.4)alkyl, 3-pyridyl(C.sub.1 -C.sub.4)alkyl-, 4-pyridyl-(C.sub.1 -C.sub.4)alkyl, phenyl-CH.sub.2 --S--CH.sub.2 --, thienyl-(C.sub.1 -C.sub.4)alkyl-, phenyl-(C.sub.0 -C.sub.3)alkyl-O--CH.sub.2 --, phenyl-CH.sub.2 --O-phenyl-CH.sub.2 --, 3-benzothienyl-CH.sub.2 --, thienyl-CH.sub.2 --O--CH.sub.2 --, thiazolyl-CH.sub.2 --O--CH.sub.2 --, pyridyl-CH.sub.2 --O--CH.sub.2 --, pyrimidyl-CH.sub.2 --O--CH.sub.2 -- and phenyl-O--CH.sub.2 --CH.sub.2 ; PA1 R.sup.2 is methyl; A.sup.1 is 2-pyridyl; and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -phenyl; PA1 R.sup.2 is CH.sub.2 CF.sub.3 ; A.sup.1 is 2-pyridyl; and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -3-chloro-phenyl; PA1 R.sup.2 is CH.sub.2 CF.sub.3 ; A.sup.1 is 2-pyridyl; and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -4-chloro-phenyl; PA1 R.sup.2 is CH.sub.2 CF.sub.3 ; A.sup.1 is 2-pyridyl; and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -2,4-di-chloro-phenyl; PA1 R.sup.2 is CH.sub.2 CF.sub.3 ; A.sup.1 is 2-pyridyl; and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -3-chloro-thiophene; or PA1 R.sup.2 is CH.sub.2 CF.sub.3 ; A.sup.1 is 2-pyridyl; and R.sup.3 is --CH.sub.2 --O--CH.sub.2 -2,4-di-fluoro-phenyl. PA1 R.sup.1 is hydrogen, --CN, --(CH.sub.2).sub.q N(X.sup.6)C(O)X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 (CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.8)SO.sub.2 X.sup.8, --(CH.sub.2).sub.q N(X.sup.8)C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q C(O)OX.sup.8, --(CH.sub.2).sub.q C(O)O(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OX.sup.8, --(CH.sub.2).sub.q OC(O)X.sup.6, --(CH.sub.2).sub.q OC(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)X.sup.6, --(CH.sub.2).sub.q C(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)OX.sup.6, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q S(O).sub.m X.sup.6, --(CH.sub.2).sub.q S(O).sub.m (CH.sub.2).sub.t --A.sup.1, --(C.sub.1 -C.sub.10)alkyl, --(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q --(C.sub.3 -C.sub.7)cycloalkyl, --(CH.sub.2).sub.q --Y.sup.1 --(C.sub.1 -C.sub.6)alkyl, --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --A.sup.1 or --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --(C.sub.3 -C.sub.7)cycloalkyl; PA1 R.sup.2 is hydrogen, (C.sub.1 -C.sub.8)alkyl, --(C.sub.0 -C.sub.3)alkyl-(C.sub.3 -C.sub.8)cycloalkyl, --(C.sub.1 -C.sub.4)alkyl-A.sup.1 or A.sup.1 ; where the alkyl groups and the cycloalkyl groups in the definition of R.sup.2 are optionally substituted by hydroxyl, --C(O)OX.sup.6, --C(O)N(X.sup.6)(X.sup.6), --N(X.sup.8)(X.sup.8), --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)A.sup.1, --C(O)(X.sup.6), CF.sub.3, CN or 1 to 3 halogen; PA1 A.sup.1 for each occurrence is independently (C.sub.5 -C.sub.7)cycloalkenyl, phenyl or a partially saturated, fully saturated or fully unsaturated 4- to 8-membered ring optionally having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen, or a bicyclic ring system consisting of a partially saturated, fully unsaturated or fully saturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen, fused to a partially saturated, fully saturated or fully unsaturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen; PA1 A.sup.1 for each occurrence is independently optionally substituted, in one or optionally both rings if A.sup.1 is a bicyclic ring system, with up to three substituents, each substituent independently selected from the group consisting of F, Cl, Br, I, OCF.sub.3, OCF.sub.2 H, CF.sub.3, CH.sub.3, OCH.sub.3, --OX.sup.6, --C(O)N(X.sup.6)(X.sup.6), --C(O)OX.sup.6, oxo, (C.sub.1 -C.sub.6)alkyl, nitro, cyano, benzyl, --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, 1H-tetrazol-5-yl, phenyl, phenoxy, phenylalkyloxy, halophenyl, methylenedioxy, --N(X.sup.6)(X.sup.6), --N(X.sup.6)C(O)(X.sup.6), --SO.sub.2 N(X.sup.6)(X.sup.6), --N(X.sup.6)SO.sub.2 -phenyl, --N(X.sup.6)SO.sub.2 X.sup.6, --CONX.sup.11 X.sup.12, --SO.sub.2 NX.sup.11 X.sup.12, --NX.sup.6 SO.sub.2 X.sup.12, --NX.sup.6 CONX.sup.11 X.sup.12, --NX.sup.6 SO.sub.2 NX.sup.11 X.sup.12, --NX.sup.6 C(O)X.sup.12, imidazolyl, thiazolyl and tetrazolyl, provided that if A.sup.1 is optionally substituted with methylenedioxy then it can only be substituted by one methylenedioxy; PA1 X.sup.2 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, or optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, where the optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.2 are optionally independently substituted with --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)OX.sup.3, 1 to 5 halogens or 1 to 3 OX.sup.3 ; PA1 X.sup.3 for each occurrence is independently hydrogen or (C.sub.1 -C.sub.6)alkyl; PA1 X.sup.6 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, (C.sub.2 -C.sub.8)halogenated alkyl, optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, (C.sub.3 -C.sub.7)-halogenatedcycloalkyl, where optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.6 is optionally independently substituted by, hydroxyl, (C.sub.1 -C.sub.4)alkoxy, carboxyl, CONH.sub.2, --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --CO.sub.2 (C.sub.1 -C.sub.4)alkyl, 1H-tetrazol-5-yl or 1 or 2 (C.sub.1 -C.sub.4)alkyl; or PA1 X.sup.7 is hydrogen or (C.sub.1 -C.sub.6)alkyl optionally substituted with hydroxyl; and PA1 m for each occurrence is independently 0, 1 or 2; PA1 X.sup.6 and X.sup.12 cannot be hydrogen when it is attached to C(O) or SO.sub.2 in the form C(O)X.sup.6, C(O)X.sup.12, SO.sub.2 X.sup.6 or SO.sub.2 X.sup.12 ; and when R.sup.2 is hydrogen then R.sup.1 is not --CH.dbd.CH-phenyl. PA1 R.sup.1 is hydrogen, --CN, --(CH.sub.2).sub.q N(X.sup.6)C(O)X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 (CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q C(O)OX.sup.6, --(CH.sub.2).sub.q C(O)O(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OX.sup.6, --(CH.sub.2).sub.q OC(O)X.sup.6, --(CH.sub.2).sub.q OC(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)X.sup.6, --(CH.sub.2).sub.q C(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)OX.sup.6, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q S(O).sub.m X.sup.6, --(CH.sub.2).sub.q S(O).sub.m (CH.sub.2).sub.t --A.sup.1, --(C.sub.1 -C.sub.10)alkyl, --(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q --(C.sub.3 -C.sub.7)cycloalkyl, --(CH.sub.2).sub.q --Y.sup.1 --(C.sub.1 -C.sub.6)alkyl, --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --A.sup.1 or --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --(C.sub.3 -C.sub.7)cycloalkyl; PA1 R.sup.2 is hydrogen, (C.sub.1 -C.sub.8)alkyl, --(C.sub.0 -C.sub.3)alkyl-(C.sub.3 -C.sub.8)cycloalkyl, --(C.sub.1 -C.sub.4)alkyl-A.sup.1 or A.sup.1 ; where the alkyl groups and the cycloalkyl groups in the definition of R.sup.2 are optionally substituted with hydroxyl, --C(O)OX.sup.6, --C(O)N(X.sup.6)(X.sup.6), --N(X.sup.6)(X.sup.6), --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)A.sup.1, --C(O)(X.sup.6), CF.sub.3, CN or 1 to 3 halogen; PA1 A.sup.1 for each occurrence is independently (C.sub.5 -C.sub.7)cycloalkenyl, phenyl or a partially saturated, fully saturated or fully unsaturated 4- to 8-membered ring optionally having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen, or a bicyclic ring system consisting of a partially saturated, fully unsaturated or fully saturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen, fused to a partially saturated, fully saturated or fully unsaturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen; PA1 X.sup.2 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, or optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, where the optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.2 are optionally independently substituted with --S(O).sub.m (C.sub.1 -C.sub.8)alkyl, --C(O)OX.sup.3, 1 to 5 halogens or 1 to 3 OX.sup.3 ; PA1 X.sup.3 for each occurrence is independently hydrogen or (C.sub.1 -C.sub.6)alkyl; PA1 X.sup.6 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, (C.sub.2 -C.sub.6)halogenated alkyl, optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, (C.sub.3 -C.sub.7)-halogenatedcycloalkyl, where optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.6 is optionally independently substituted with hydroxyl, (C.sub.1 -C.sub.4)alkoxy, carboxyl, CONH.sub.2, --S(O).sub.m (C.sub.1 -C.sub.8)alkyl, --CO.sub.2 (C.sub.1 -C.sub.4)alkyl, 1H-tetrazol-5-yl or 1 or 2 (C.sub.1 -C.sub.4)alkyl; or PA1 X.sup.7 is hydrogen or (C.sub.1 -C.sub.6)alkyl optionally substituted with hydroxyl; and m for each occurrence is independently 0, 1 or 2; PA1 X.sup.6 and X.sup.12 cannot be hydrogen when it is attached to C(O) or SO.sub.2 in the form C(O)X.sup.6, C(O)X.sup.12, SO.sub.2 X.sup.6 or SO.sub.2 X.sup.12 ; PA1 when R.sup.2 is hydrogen then R.sup.1 is not --CH.dbd.CH-phenyl; PA1 when R.sup.2 is H and R.sup.1 is --CH.sub.2 --CH.dbd.CH--Ph, then Z.sup.100 is not BOC; PA1 when R.sup.2 is H and R.sup.1 is then Z.sup.100 is not BOC; PA1 when R.sup.2 is H and R.sup.1 is --CH.sub.2 --C(CH.sub.2).dbd.CH.sub.3, then Z.sup.100 is not BOC; and PA1 when R.sup.2 is phenyl and R.sup.1 is --CH.sub.3, then Z.sup.100 is not CH.sub.3 C(O)--. PA1 Z.sup.100 is BOC, methyl, benzyl or CBZ; PA1 R.sup.1 is hydrogen, --(CH.sub.2).sub.q --(C.sub.3 -C.sub.7)cycloalkyl, --(CH.sub.2).sub.t --A.sup.1 or (C.sub.1 -C.sub.10)alkyl where the (C.sub.1 -C.sub.10)alkyl and (C.sub.3 -C.sub.7)cycloalkyl groups are optionally substituted with 1 to 3 fluoro and A.sup.1 in the definition of R.sup.1 is optionally substituted with 1 to 3 substituents independently selected from the group consisting of F, Cl, Me, OMe, CF.sub.3, OCF.sub.3 and OCF.sub.2 H; PA1 R.sup.2 is hydrogen, (C.sub.1 -C.sub.8)alkyl, --(C.sub.0 -C.sub.3)alkyl-(C.sub.3 -C.sub.7)cycloalkyl, phenyl, or --(C.sub.1 -C.sub.3)alkyl-phenyl where the alkyl and phenyl groups are optionally substituted with 1 to 3 substituents independently selected from the group consisting of F, CF.sub.3, OH and OMe. PA1 e is 0 or 1; PA1 n and w are each independently 0, 1 or 2, provided that w and n cannot both be 0 at the same time; PA1 Y is oxygen or sulfur; PA1 R.sup.1 is hydrogen, --CN, --(CH.sub.2).sub.q N(X.sup.6)C(O)X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 (CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 X.sup.6, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.6)C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q C(O)OX.sup.6, --(CH.sub.2).sub.q C(O)O(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OX.sup.8, --(CH.sub.2).sub.q OC(O)X.sup.6, --(CH.sub.2).sub.q OC(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q OC(O)N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q C(O)X.sup.6, --(CH.sub.2).sub.q C(O)(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q N(X.sup.8)C(O)OX.sup.6, --(CH.sub.2).sub.q N(X.sup.6)SO.sub.2 N(X.sup.6)(X.sup.6), --(CH.sub.2).sub.q S(O).sub.m X.sup.6, --(CH.sub.2).sub.q S(O).sub.m (CH.sub.2).sub.t --A.sup.1, --(C.sub.1 -C.sub.10)alkyl, --(CH.sub.2).sub.t --A.sup.1, --(CH.sub.2).sub.q --(C.sub.3 -C.sub.7)cycloalkyl, --(CH.sub.2).sub.q --Y.sup.1 --(C.sub.1 -C.sub.6)alkyl, --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --A.sup.1 or --(CH.sub.2).sub.q --Y.sup.1 --(CH.sub.2).sub.t --(C.sub.3 -C.sub.7)cycloalkyl; PA1 Y.sup.1 is O, S(O).sub.m, --C(O)NX.sup.6, --CH.dbd.CH--, --C.tbd.C--, --N(X.sup.6)C(O), --C(O)NX.sup.6, --C(O)O, --OC(O)N(X.sup.6) or --OC(O); PA1 q is 0, 1, 2, 3 or 4; PA1 t is 0, 1, 2 or 3; PA1 said (CH.sub.2).sub.q group and (CH.sub.2).sub.t group may each be optionally substituted with hydroxyl, (C.sub.1 -C.sub.4)alkoxy, carboxyl, --CONH.sub.2, --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --CO.sub.2 (C.sub.1 -C.sub.4)alkyl, 1H-tetrazol-5-yl, 1 to 3 fluoro or 1 or 2 (C.sub.1 -C.sub.4)alkyl; PA1 R.sup.2 is hydrogen, (C.sub.1 -C.sub.8)alkyl, --(C.sub.0 -C.sub.3)alkyl-(C.sub.3 -C.sub.8)cycloalkyl, --(C.sub.1 -C.sub.4)alkyl-A.sup.1 or A.sup.1 ; PA1 R.sup.3 is A.sup.1, (C.sub.1 -C.sub.10)alkyl, --(C.sub.1 -C.sub.6)alkyl-A.sup.1, --(C.sub.1 -C.sub.6)alkyl-(C.sub.3 -C.sub.7)cycloalkyl, --(C.sub.1 -C.sub.5)alkyl-X.sup.1 --(C.sub.1 -C.sub.5)alkyl, --(C.sub.1 -C.sub.5)alkyl-X.sup.1 --(C.sub.0 -C.sub.5)alkyl-A.sup.1 or --(C.sub.1 -C.sub.5)alkyl-X.sup.1 --(C.sub.1 -C.sub.5)alkyl-(C.sub.3 -C.sub.7)cycloalkyl; PA1 where the alkyl groups in the definition of R.sup.3 is optionally substituted with --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)OX.sup.3, 1 to 5 halogens or 1 to 3 OX.sup.3 ; PA1 X.sup.1 is O, S(O).sub.m, --N(X.sup.2)C(O)--, --C(O)N(X.sup.2)--, --OC(O)--, --C(O)O--, --CX.sup.2 .dbd.CX.sup.2 --, --N(X.sup.2)C(O)O--, --OC(O)N(X.sup.2)-- or --C.tbd.C--; PA1 R.sup.4 is hydrogen, (C.sub.1 -C.sub.6)alkyl or (C.sub.3 -C.sub.7)cycloalkyl, or R.sup.4 is taken together with R.sup.3 and the carbon atom to which they are attached and form (C.sub.5 -C.sub.7)cycloalkyl, (C.sub.5 -C.sub.7)cycloalkenyl, a partially saturated or fully saturated 4- to 8-membered ring having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen, or is a bicyclic ring system consisting of a partially saturated or fully saturated 5- or 6-membered ring, fused to a partially saturated, fully unsaturated or fully saturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen; PA1 X.sup.4 is hydrogen or (C.sub.1 -C.sub.6)alkyl or X.sup.4 is taken together with R.sup.4 and the nitrogen atom to which X.sup.4 is attached and the carbon atom to which R.sup.4 is attached and form a five to seven membered ring; PA1 R.sup.6 is a bond or is ##STR13## where a and b are independently 0, 1, 2 or 3; X.sup.5 and X.sup.5a are each independently selected from the group consisting of hydrogen, trifluoromethyl, A.sup.1 and optionally substituted (C.sub.1 -C.sub.6)alkyl; PA1 R.sup.8 is hydrogen or optionally substituted (C.sub.1 -C.sub.6)alkyl; PA1 A.sup.1 for each occurrence is independently (C.sub.5 -C.sub.7)cycloalkenyl, phenyl or a partially saturated, fully saturated or fully unsaturated 4- to 8-membered ring optionally having 1 to 4 heteroatoms independently selected from the group consisting of oxygen, sulfur and nitrogen, or a bicyclic ring system consisting of a partially saturated, fully unsaturated or fully saturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen, fused to a partially saturated, fully saturated or fully unsaturated 5- or 6-membered ring, optionally having 1 to 4 heteroatoms independently selected from the group consisting of nitrogen, sulfur and oxygen; PA1 A.sup.1 for each occurrence is independently optionally substituted, in one or optionally both rings if A.sup.1 is a bicyclic ring system, with up to three substituents, each substituent, independently selected from the group consisting of F, Cl, Br, I, OCF.sub.3, OCF.sub.2 H, CF.sub.3, CH.sub.3, OCH.sub.3, --OX.sup.6, --C(O)N(X.sup.6)(X.sup.6), --C(O)OX.sup.6, oxo, (C.sub.1 -C.sub.6)alkyl, nitro, cyano, benzyl, --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, 1H-tetrazol-5-yl, phenyl, phenoxy, phenylalkyloxy, halophenyl, methylenedioxy, --N(X.sup.6)(X.sup.6), --N(X.sup.6)C(O)(X.sup.6), --SO.sub.2 N(X.sup.6)(X.sup.6), --N(X.sup.16)SO.sub.2 -phenyl, --N(X.sup.6)SO.sub.2 X.sup.6, --CONX.sup.11 X.sup.12, --SO.sub.2 NX.sup.11 X.sup.12, --NX.sup.6 SO.sub.2 X.sup.12, --NX.sup.6 CONX.sup.11 X.sup.12, --NX.sup.6 SO.sub.2 NX.sup.11 X.sup.12, --NX.sup.6 C(O)X.sup.12, imidazolyl, thiazolyl and tetrazolyl, provided that if A.sup.1 is optionally substituted with methylenedioxy then it can only be substituted with one methylenedioxy; PA1 r for each occurrence is independently 1, 2 or 3; PA1 X.sup.2 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, or optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, where the optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.2 are optionally independently substituted with --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --C(O)OX.sup.3, 1 to 5 halogens or 1 to 3 --OX.sup.3 ; PA1 X.sup.3 for each occurrence is independently hydrogen or (C.sub.1 -C.sub.6)alkyl; PA1 X.sup.6 for each occurrence is independently hydrogen, optionally substituted (C.sub.1 -C.sub.6)alkyl, (C.sub.2 -C.sub.6)halogenated alkyl, optionally substituted (C.sub.3 -C.sub.7)cycloalkyl, (C.sub.3 -C.sub.7)-halogenatedcycloalkyl, where optionally substituted (C.sub.1 -C.sub.6)alkyl and optionally substituted (C.sub.3 -C.sub.7)cycloalkyl in the definition of X.sup.6 is optionally independently substituted with hydroxyl, (C.sub.1 -C.sub.4)alkoxy, carboxyl, CONH.sub.2, --S(O).sub.m (C.sub.1 -C.sub.6)alkyl, --CO.sub.2 (C.sub.1 -C.sub.4)alkyl, 1H-tetrazol-5-yl or 1 or 2 (C.sub.1 -C.sub.4)alkyl; or when there are two X.sup.8 groups on one atom and both X.sup.6 are (C.sub.1 -C.sub.6)alkyl, the two (C.sub.1 -C.sub.8)alkyl groups may be optionally joined and, together with the atom to which the two X.sup.8 groups are attached, form a 4- to 9- membered ring optionally having oxygen, sulfur or NX.sup.7 ; PA1 X.sup.7 is hydrogen or (C.sub.1 -C.sub.6)alkyl optionally substituted by hydroxyl; and m for each occurrence is independently 0, 1 or 2; PA1 X.sup.6 and X.sup.12 cannot be hydrogen when it is attached to C(O) or SO.sub.2 in the form C(O)X.sup.6, C(O)X.sup.12, SO.sub.2 X.sup.6 or SO.sub.2 X.sup.12 ; and when R.sup.6 is a bond then L is N(X.sup.2) and each r in the definition --(CH.sub.2).sub.r --L--(CH.sub.2).sub.r -- is 2 or 3. PA1 cis-6-(4-hydroxyphenyl)-5-[4-(2-piperidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetr ahydro-naphthalene-2-ol; or PA1 1-(4'-pyrrolidinolethoxyphenyl)-2-phenyl-6-hydroxy-1,2,3,4-tetrahydro-isoqu inoline and a compound of Formula I; PA1 a method for the treatment of osteoporosis which comprises administering to a human or other animal with osteoporosis a combination of calcitonin and a compound of Formula I; PA1 a method for increasing muscle mass, which method comprises administering to a human or other animal in need of such treatment an amount of a compound of Formula I which is effective in promoting release of endogenous growth hormone; and PA1 a method for promoting growth in growth hormone deficient children which comprises administering to a growth hormone deficient child a compound of Formula I which is effective in promoting release of endogenous growth hormone. PA1 cis-6-(4-fluoro-phenyl)-5-[4-(2-piperidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetr ahydro-naphthalene-2-ol; PA1 (-)-cis-6-phenyl-5-[4-(2-pyrrolidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetrahydro -naphthalene-2-ol; PA1 cis-6-phenyl-5-[4-(2-pyrrolidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetrahydro-nap hthalene-2-ol; PA1 cis-1-[6'-pyrrolodinoethoxy-3'-pyridyl]-2-phenyl-6-hydroxy-1,2,3,4-tetrahyd ronaphthalene; PA1 1-(4'-pyrrolidinoethoxyphenyl)-2-(4"-fluorophenyl)-6-hydroxy-1,2,3,4-tetrah ydroisoquinoline; PA1 cis-6-(4-hydroxyphenyl)-5-[4-(2-piperidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetr ahydro-naphthalene-2-ol; and PA1 1-(4'-pyrrolidinolethoxyphenyl)-2-phenyl-6-hydroxy-1,2,3,4-tetrahydroisoqui noline. PA1 cis-6-(4-fluoro-phenyl)-5-[4-(2-piperidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetr ahydro-naphthalene-2-ol; PA1 (-)-cis-6-phenyl-5-[4-(2-pyrrolidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetrahydro -naphthalene-2-ol; PA1 cis-6-phenyl-5-[4-(2-pyrrolidin-1-yl-ethoxy)-phenyl]5,6,7,8-tetrahydro-naph thalene-2-ol; PA1 cis-1-[6'-pyrrolodinoethoxy-3'-pyridyl]-2-phenyl-6-hydroxy-1,2,3,4-tetrahyd ronaphthalene; PA1 1-(4'-pyrrolidinoethoxyphenyl)-2-(4"-fluorophenyl)-6-hydroxy-1,2,3,4-tetrah ydroisoquinoline; PA1 cis-6-(4-hydroxyphenyl)-5-[4-(2-piperidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetr ahydro-naphthalene-2-ol; or PA1 1-(4'-pyrrolidinolethoxyphenyl)-2-phenyl-6-hydroxy-1,2,3,4-tetrahydroisoqui noline is in the range of 0.0001 to 100 mg/kg/day, preferably 0.001 to 10 mg/kg/day.
Deficiency in growth hormone results in a variety of medical disorders. In children, it causes dwarfism. In adults, the consequences of acquired GH deficiency include profound reduction in lean body mass and concomitant increase in total body fat, particularly in the truncal region. Decreased skeletal and cardiac muscle mass and muscle strength lead to a significant reduction in exercise capacity. Bone density is also reduced. Administration of exogenous growth hormone has been shown to reverse many of the metabolic changes. Additional benefits of therapy have included reduction in LDL cholesterol and improved psychological well-being.
In cases where increased levels of growth hormone were desired, the problem was generally solved by providing exogenous growth hormone or by administering an agent which stimulated growth hormone production and/or release. In either case the peptidyl nature of the compound necessitated that it be administered by injection. Initially the source of growth hormone was the extraction of the pituitary glands of cadavers. This resulted in an expensive product, and carried with it the risk that a disease associated with the source of the pituitary gland could be transmitted to the recipient of the growth hormone (e.g., Jacob-Cruetzfeld disease). Recently, recombinant growth hormone has become available which, while no longer carrying any risk of disease transmission, is still a very expensive product which must be given by injection or by a nasal spray.
Most GH deficiencies are caused by defects in GH release, not primary defects in pituitary synthesis of GH. Therefore, an alternative strategy for normalizing serum GH levels is by stimulating its release from somatotrophs. Increasing GH secretion can be achieved by stimulating or inhibiting various neurotransmitter systems in the brain and hypothalamus. As a result, the development of synthetic growth hormone-releasing agents to stimulate pituitary GH secretion are being pursued, and may have several advantages over expensive and inconvenient GH replacement therapy. By acting along physiologic regulatory pathways, the most desirable agents would stimulate pulsatile GH secretion, and excessive levels of GH that have been associated with the undesirable side effects of exogenous GH administration would be avoided by virtue of intact negative feedback loops.
Physiologic and pharmacologic stimulators of GH secretion include arginine, L-3,4-dihydroxyphenylalanine (L-DOPA), glucagon, vasopressin, and insulin induced hypoglycemia, as well as activities such as sleep and exercise, indirectly cause growth hormone to be released from the pituitary by acting in some fashion on the hypothalamus perhaps either to decrease somatostatin secretion or to increase the secretion of the known secretagogue growth hormone releasing factor (GHRF) or an unknown endogenous growth hormone-releasing hormone or all of these.
Other compounds have been developed which stimulate the release of endogenous growth hormone such as analogous peptidyl compounds related to GRF or the peptides of U.S. Pat. No. 4,411,890. These peptides, while considerably smaller than growth hormones are still susceptible to various proteases. As with most peptides, their potential for oral bioavailability is low. WO 94/13696 refers to certain spiropiperidines and homologues which promote release of growth hormone. Preferred compounds are of the general structure shown below. ##STR2##
WO 94/11012 refers to certain dipeptides that promote release of growth hormone. These dipeptides have the general structure ##STR3## where L is ##STR4##
The compounds of WO 94/11012 and WO 94/13696 are reported to be useful in the treatment of osteoporosis in combination with parathyroid hormone or a bisphosphonate.